Crespo, MartaMazuecos, AuxiliadoraRodrigo, EmilioGavela, EvaVillanego, FlorentinoSánchez-Alvarez, EmilioGonzález-Monte, EstherJiménez-Martín, CarlosMelilli, EdoardoDiekman, FritzZárraga, SofíaHernández, DomingoPascual, JulioSpanish Society of Nephrology COVID-19 Group2023-02-092023-02-092020http://hdl.handle.net/10668/16112Coronavirus infectious disease 2019 (COVID-19) pandemic has posed at risk the kidney transplant (KT) population. We describe clinical pictures, risk factors for death, and chances to recovery in a large cohort of KT recipients with COVID-19. Inclusion in a Spanish prospectively filled registry was allowed for KT cases with confirmed COVID-19. Outcomes were assessed as in-hospital mortality or recovery. The study population comprised of 414 patients. Fever, respiratory symptoms, and dyspnea were the most frequent COVID-19-related symptoms, and 81.4% of them had pneumonia. More than one-third of patients showed digestive symptoms at diagnosis, combinations of nausea, vomiting, and diarrhea. Most patients were hospitalized, 12.1% in intensive care units, and 17.6% needed ventilator support. Treatment for COVID-19 included frequently hydroxychloroquine, azithromycin, high-dose steroids, lopinavir/ritonavir, and tocilizumab. After a mean follow-up of 44 days, the fatality rate was 26.3%. Pneumonia without gastrointestinal symptoms was associated with a 36.3% mortality (respiratory phenotype), and gastrointestinal symptoms without pneumonia with a 5.3% mortality (gastrointestinal phenotype). The mixed pneumonia and gastrointestinal phenotype showed an intermediate mortality of 19.5% (mixed phenotype). Multivariate Cox regression analysis showed that age and pneumonia were independently associated with death, whereas the gastrointestinal phenotype was associated with recovery. COVID-19 is frequent among the KT population. Advanced age and pneumonia are the main clinical features associated with a high-mortality rate. Gastrointestinal disease is associated with a more benign course and lower mortality.enAgedBetacoronavirusCOVID-19Coronavirus InfectionsFemaleGastrointestinal DiseasesHospital MortalityHumansKidney TransplantationMaleMiddle AgedMultivariate AnalysisPandemicsPhenotypePneumonia, ViralProportional Hazards ModelsRegistriesRegression AnalysisRespiratory Tract DiseasesSARS-CoV-2SpainSurvival RateTransplant Recipientsresearch article32804802open access10.1097/TP.00000000000034131534-6080https://journals.lww.com/transplantjournal/Fulltext/2020/11000/Respiratory_and_Gastrointestinal_COVID_19.5.aspx